Application for Board or Commission Membership

To apply for a position on a Larimer County Board or Commission, fill out the following form and press the
Submit button. Thank you for your interest.

Fields marked * are required

Leave this field empty

*Name:

*Address 1:

Address 2:

*City:

*State:*Zip:

*Home Phone:

Work Phone:

*E-mail:

*Board you are applying for:

(Submit one application for each board or commission membership.
You may apply for up to 3 boards at a time)

If you are applying to more than one board, please indicate whether this is your
First Second Third choice

*Improvement District you are applying for:

*Length of residence in Larimer County:

*Current occupation and employer:

*Prior work experience:

*Have you ever been convicted of a felony:
No
Yes

Volunteer work:

Are you presently serving on a County board or commission? If so, which one?

*Why do you want to be a member of this particular board or commission?

*Briefly, what do you believe are the three most important issues facing the Larimer County community at this time, and how do you believe this board or commission can play a role in addressing each issue?

List any abilities, skills, licenses, certificates, specialized training, or interests you have which are applicable to this board or commission.

Please specify any activities in which you are presently engaged or in which you plan to be engaged which might create a serious conflict of interest if you should be appointed to this board or commission.

*If your application is chosen for an interview, what day(s)/time(s) are you available?

All applicants are strongly encouraged to attend a regularly scheduled meeting of the board
or commission for which they are applying. Frequent non-attendance may result in termination of the appointment.

Optional: Where did you learn about openings for this board? Check all that apply and list name(s)